Individual provider Active NPI

Elisha Jana Jackson, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • New Haven, CT
National Provider Identifier
1346506482
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
81231 Issued in TX
Practice address
333 Cedar St
New Haven, CT 06510-3206
Phone
(203) 432-4771
NPI assigned
Apr 3, 2012
Last updated
Aug 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X 81231 TX Primary

Addresses

Primary practice location

333 Cedar St
New Haven, CT 06510-3206

Mailing address

8703 Morris Woods Dr
Missouri City, TX 77459-3888
Phone (816) 686-0222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190918003413 TX Practitioner - Obstetrics/Gynecology 1951631845 Reassigns benefits to 3 organizations
I20250716002810 CT Practitioner - Obstetrics/Gynecology 1951631845 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Kansas School of Med (KC/Wich/Sal), 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians
Cornell Scott Hill Health CorporationGroup PAC ID 3072418359, 261 clinicians

Practice addresses (Care Compare)

111 Goose LN
Guilford, CT 06437-5101
Phone (203) 747-7300

428 Columbus Ave
New Haven, CT 06519-1233
Phone (203) 503-3228

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.88 of 100Reported as group
Quality
73.38
Improvement activities
40
Cost
78.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
81231TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Dec 17, 2019 Accepting new patients
Baylor College of Medicine CurrentSince Dec 17, 2019 Accepting new patients
Yale University CurrentSince Oct 23, 2025 Accepting new patients
Yale University CurrentSince Oct 23, 2025 Accepting new patients
Texas Children's Physician Group CurrentSince Aug 28, 2019 Accepting new patients
Cornell Scott Hill Health Corporation CurrentSince Jul 11, 2025 Accepting new patients
Utmb Faculty Group Practice CurrentSince Jun 15, 2021 Accepting new patients
University of Texas Medical Branch at Galveston Past Accepting new patients

Locations

111 Goose Ln
Guilford, CT 06437
Phone (203) 453-7100

428 Columbus Ave
New Haven, CT 06519
Phone (203) 503-3228

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

2020 E Highway 6
Alvin, TX 77511
Phone (281) 585-2530

146 E Hospital Dr
Ste 208
Angleton, TX 77515
Phone (979) 848-9110

195 N 11th St
Beaumont, TX 77702
Phone (409) 838-0045

701 E Davis St
Ste A
Conroe, TX 77301
Phone (936) 525-2800

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

2450 Holcombe Blvd
Ste NB34L
Houston, TX 77021
Phone (713) 796-0003

6651 Main St
Ste F320
Houston, TX 77030
Phone (512) 828-3660

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

511 Park Grove Dr
Katy, TX 77450
Phone (281) 398-7001

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

Interoperability endpoints

  • Direct secure messaging: ejacksonmd51372@direct.utmb.edu

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1346506482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8703 MORRIS WOODS DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774593888",
            "telephone_number": "816-686-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CEDAR ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103206",
            "telephone_number": "203-432-4771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ELISHA",
        "middle_name": "JANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-03",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "TX",
            "license": "81231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.